[Coronary angioplasty in patients not accepted for surgical treatment. The initial experience of the Ignacio Chávez Instituto Nacional de Cardiología].

Coronary angioplasty has shown its efficacy in "high-risk" patients for surgical treatment (severe left ventricular failure, serious pulmonary or systemic disease). We studied a subgroup with multivessel coronary heart disease treated with coronary angioplasty because they were no candidates for surgery due to unsuitable coronary anatomy. Revascularization rate was determined in each patient as revascularization percentage obtained, compared with all the technically suitable lesions for coronary angioplasty. Ten patients (mean age 63 years) were studied, eight of them had unstable angina. Overall, 44 lesions were considered technically suitable for angioplasty and thirty-five could be dilated, technical success rate was 88% (31/35 lesions) and revascularization rate was 71% (31/44 lesions). Primary success rate was achieved in nine patients. Clinical follow-up varied from two to thirteen months (mean 7.8 months); eight patients have remained asymptomatic (class I of NYHA), another patient had stable angina and the other one had sudden death six months after the procedure. In conclusion, we demonstrated a high success rate in a short and long term with coronary angioplasty in a subgroup of patients with multivascular coronary heart disease that had been rejected for surgery due to unsuitable coronary anatomy.